Why not repeal and replace?

Republicans have simple answers to every question, simple solutions to every problem. Simple solutions that don’t work.

Health care is no exception. Republicans simply say “repeal and replace.” They’re talking about the Affordable Care Act, more popularly known as Obamacare.

They’ve got the repeal part down. Since the law was approved in 2010, Congressional Republicans have voted more than 60 times to repeal the Affordable Care Act. It’s the replace part that has them stumped. They offered no alternative in the past, and haven’t yet figured out what to put in its place.

It should be noted that all those votes were taken to repeal the law when GOP lawmakers weren’t actually in a position to make it happen. They were merely posturing. Now they are in control of both houses of Congress and will be working with a Republican president who says he’s committed to repealing and replacing Obamacare. There’s nothing standing in their way anymore. Except for the politically uncomfortable fact that only about a quarter of Americans want to see the law repealed. And that pesky business of coming up with something to replace it with.

If the new Congress and the new inhabitants of the White House are bound and determined to repeal and replace Obamacare, then do it right. Do it in a way that makes health care more accessible and affordable. Do it in a way that makes the health care system less bureaucratic and brings down administrative overhead costs. Here’s how. Repeal the law, then roll the existing Medicare and Medicaid programs into one and call it Americare. Make every American eligible for it. No one would be forced to enroll. If you want to continue to buy private insurance, you should be free to do so. But Americare would be there for everyone who wants it.

Two federal programs and their accompanying bureaucracies as well as the federal infrastructure devoted to administering the Affordable Care Act and its insurance exchanges would be brought under a single roof, making the federal health care system more streamlined and efficient. Medicare provides a sturdy foundation upon which to build Americare. Medicare is well established and widely supported by the seniors it serves, so popular that one of the signs most commonly seen at Tea Party rallies carried the message “Keep Government Out of My Medicare” or some variation on that theme.

Any program that has earned that kind of loyalty from Tea Partiers and is so highly valued by the nation’s elderly should be made available to Americans of all ages. All Americans should be allowed to benefit from the fact that Medicare does a far better job of controlling costs and is much more administratively efficient than the rest of the U.S. health care system.

Our country is ranked at or near the bottom in the developed world in the efficiency and effectiveness of health care. We spend more and get less. We can do better. Way better.

Out with Obamacare. In with Americare.

Mike McCabe